7/30/2019 Gasto Ventricular

1/43

7/30/2019 Gasto Ventricular

2/43

H`hjyqnjeqidncqeke

Fezhz ih` Jdj`nJeqiejn

_qhzdmVhmyqdjx`eqDwuxdhqie

7/30/2019 Gasto Ventricular

3/43

7/30/2019 Gasto Ventricular

4/43

7/30/2019 Gasto Ventricular

5/43

FXMJDM JEQIEJE

Zzyn`h 7

H` vhmyqjx`n h|px`ze 3? k` ih zemcqh e

51? kkLc ih pqhzdm-

Idzyn`h 7

H` vhmyqjx`n zh ``hme jnm 51? k` ih

zemcqh e xme pqhzdm mn ketnq ih

5? kkLc-

7/30/2019 Gasto Ventricular

6/43

FXMJDM JEQIEJE

Vn`xkhm idezy`djn fdme` ; 51? k` ,VIF$

Vn`xkhm zdzy`djn fdme` ; 8? k` ,VZF$

Vn`xkhm ih h|px`zdm ; 3? k` ,VH$ VZF | 5?? . VIF ; Fqejjdm ih hthjjdm

3? | 5?? ; 8< e 6? (

51?

7/30/2019 Gasto Ventricular

7/43

CEZYN JEQIEJN

Jemydiei ih zemcqh uxh h|px`ze h` jnqewmhm xm kdmxyn-

Hz dcxe` e 7Vn`xkhm ih h|px`zdm | fqhjxhmjde jeqideje

VH \ FJ

CHMHQE@DIEIHZ

7/30/2019 Gasto Ventricular

8/43

CEZYN JEQIEJN

Dmidjh Jeqiejn7 qh`ejdm cezyn jeqiejn.qhezxphqfdjdh jnqpnqe`-

Mnqke` peqe 5-

7/30/2019 Gasto Ventricular

9/43

QHCX@EJDM IH@ CEZYN JEQIEJN

Fqhjxhmjde Jeqieje

Vn`xkhm ih H|px`zdm Vhmyqdjx`eq

7/30/2019 Gasto Ventricular

10/43

Idecqeke ih `nz pqdmjdpe`hz fejynqhz uxh qhcx`em h`vn`xkhm ih h|px`zdm ,VH$- YQ_7 hz `e qhzdzyhmjde

vezjx`eq phqdfqdje

7/30/2019 Gasto Ventricular

11/43

QHCX@EJDM IH@ CEZYN

JEQIEJN

H` vn`xkhm ih h|px`zdm hzye qhcx`ein pnq inz fxhqweznpnmhmyhz7

5$ Hmhqce Jnmyqjyd` ih` kdnjeqidn uxh h`hve h` cezyn jeqiejn,dmnyqnpdzkn$7

Vn`xkhm ih ``hmein vhmyqdjx`eq exynqqhcx`ejdmdmyqmzhje ,@ht ih Zyeq`dmc$

Echmyhz dmnyqpdjnz

1$ _qhzdm Eqyhqde` uxh idzkdmxth h` cezyn jeqiejn ,pnzjeqce$

7/30/2019 Gasto Ventricular

12/43

HMHQCE JNMYQJYD@ 7 CJ

Hzydqekdhmyn ih ez fdaqez e` fdm ih `e idzyn`h ;VIFV _IFV ,@ht Zyeq`dmc$

jnqqhzpnmih e `e _qhjeqce-

Jnmyqejydad`diei ,fxhqwe dmmeye$

' Zdzyhke mhqvdnzn exynmkdjn

' Zxzyemjdez lxknqe`hz' Zxzyemjdez uxkdjez

7/30/2019 Gasto Ventricular

13/43

_QHZDM EQYHQDE@ 7 C-J-

Zh npnmh e `e hthjjdm vhmyqdjx`eq ,_nzjeqce$

@e yhmzdm ejydve ih `e fdaqe jeqieje h`hve `e pqhzdmdmyqevhmyqdjx`eq ixqemyh `e fezh ih jnmyqejjdmdznvn`xkyqdje-

@e hthjjdm mn jnkdhmwe lezye uxh `e pqhzdm vhmyqdjx`eqh|jhie e `e pqhzdm eqyhqde` idezy`dje-

E = pqhzdm = hmhqce xyd`dweie hm h`hveq `e pqhzdmdmyqevhmyqdjx`eq t 0 hm `e hthjjdm-

@e _E ihphmih ih `e QV_ jxtn dmjqhkhmyn idzkdmxth h` cezynjeqiejn-

7/30/2019 Gasto Ventricular

14/43

JNMYQN@ IH@ VN@XKHM IH H\_X@ZDM

VHMYQDJX@EQ

Vn`xkhm idezy`djn fdme` ,pqhjeqce$

Jnmyqejydad`diei kdnjqidje

_qhzdm eqyhqde` ,pnzjeqce$

7/30/2019 Gasto Ventricular

15/43

JNMYQEJJDM DZNKYQDJE

JNMYQEJJDM DZNYMDJE

Ydpnz ih jnmyqejjdm ih kdnjeqidn

7/30/2019 Gasto Ventricular

16/43

JNMYQEJJDM DZNKYQDJE

_QHJEQCE + FXHQWE

@e hzydkx`ejdm ih xm kzjx`n fdgn hm zxz h|yqhknzz`n pqnixjh yhmzdm ejydve ,fxhqwe$-

Hzye jnmyqejjdm mn jnmixjh e ejnqyekdhmyn- Zh ihmnkdme dznkyqdje t hz em`nce e `e

fezh ih` jdj`n jeqiejn,fezh jnmyqejjdm dznkyqdje$

E ketnq hzydqekdhmyn ih `e fdaqe ketnq yhmzdm ihqhpnzn t ketnq yhmzdm ejydve-

7/30/2019 Gasto Ventricular

17/43

JNMYQEJJDM DZNKYQDJE

E jnmydmxejdm ih` hzydqekdhmyn ih`kdnjeqidn qh`egein e` fdm ih idzyn`h zhpqnixjh xme jnmyqejjdm kz hmqcdje-

hzye hz `e aezh ih `e 7

@HT IH FQEMB ZYEQ@DMC

7/30/2019 Gasto Ventricular

18/43

Jnmyqejjdm dznkyqdjet h` hfhjyn ih `e

`nmcdyxi ih` kzjx`nznaqh `e yhmzdm ihqhpnzn t `e yhmzdmejydve uxh zh chmhqe-

7/30/2019 Gasto Ventricular

19/43

JNMYQEJJDM DZNYMDJE

_NZJEQCE EJNQYEKDHMYN

Ejnqyekdhmyn e yhmzdm jnmzyemyh znpnqyemin xm phzn-

Hm h` vhmyqjx`n h` phzn hz `e pnzyjeqce ,_-eqyhqde`$-

Zd `e pnzyjeqce exkhmye `e vh`njdiei t `e jemydiei ihejnqyekdhmyn idzkdmxth-

Dkpnqyemjde7 `e qhixjjdm ih `e pnzyjeqce khgnqe h`ejnqyekdhmyn t exkhmye h` vn`xkhm ih h|px`zdm t h`cezyn jeqiejn-

7/30/2019 Gasto Ventricular

20/43

Qh`ejdm hmyqh `e

jnmyqejjdm dznymdje`e pnzjeqce t `e jxqveih `nmcdyxi + yhmzdm

7/30/2019 Gasto Ventricular

21/43

KHJEMDZKNZ IH @NMCDYXI + YHMZDM

5- Hm xm pqdkhq knkhmyn h` h`nmcekdhmyn ih efdaqe pqnixjh = yhmzdm zdm dmjqhkhmyn ih` Je""jdynz`djn

1- Zd h` hzydqekdhmyn hz znzyhmdin e `nz 8 kdmxynzexkhmye h` Je"" jdynp`ezkydjn

H|p`djejdm7 Jxemin `nz zeqjkhqnz znm hzydqeinzlezye 1-? xk inz fd`ekhmynz ih ejydme hzym xmnfqhmyh e` nyqn dmyhqpnmdminzh e `nz pxhmyhz ihkdnzdme- E `nmcdyxi ih 1-1 xk let ketnq jnmyejynt ketnq ejydvejdm ih `nz pxhmyhz ih ejydme tkdnzdme

7/30/2019 Gasto Ventricular

22/43

7/30/2019 Gasto Ventricular

23/43

_qhpeqejdm ih Jnqewm _x`km ih phqqn peqe

ihknzyqeq `e @ht ih Fqemb + Zyeq`dmc

7/30/2019 Gasto Ventricular

24/43

QHZ_XHZYE IH @E _QHZDM VHMNZE JHMYQE@

_QHZDM VHMNZE JHMYQE@

_QHZDM IDEZY@DJE FDME@

VN@XKHM IDEZY@DJN FDME@

= JNMYQEJJDM

= VN@XKHM IH H\_X@ZDM

= CEZYN JEQIEJN

7/30/2019 Gasto Ventricular

25/43

@E JXQVE IH

FXMJDM

VHMYQDJX@EQ

7/30/2019 Gasto Ventricular

26/43

JXQVE IH FXMJDM VHMYQDJX@EQ

Qh`ejdnme VH jnm pqhzdm ih ``hmeinvhmyqdjx`eq-

VH jnkn xme fxmjdm jxqvd`mhe lezye 5?kkLc-

Hm lxkemnz `e jxqve ih` VD e`jemwe xmekhzhye e `nz 5?kkLc-

Hm adphihzyejdm n zhmyein aege e 9 8kkLc-

_nzdjdm zxpdme ;

7/30/2019 Gasto Ventricular

27/43

Qhzxkhm ih `nz yqhz hfhjynz ih xme h`hvejdm aqxzje ih `epqhzdm eqyhqde` znaqh h` vn`xkhm ih h|px`zdm- ,5$ Dmjqhkhmynih `e pnzyjeqce qhixjh h` VH ,1$ Hfhjyn jnkphmzeynqdn7idzyhmzdm vhmyqdjx`eq ,:$ h` qhf`hgn aeqnjhpynq qhixjh h` VH

pnq idzkdmxjdm ih `e jnmyqejydad`diei

7/30/2019 Gasto Ventricular

28/43

JNMYQN@ IH@ @@HMEIN VHMYQDJX@EQ-@E _QHZDM VHMNZE JHMYQE@ ,_VJ$

Jxe`uxdhq fejynq uxh efhjyh h` vn`xkhm idezy`djnfdme` vhmyqdjx`eq ,VIF$ knidfdjeq h` cezyn jeqiejn-

VIF ihphmih ih 75- Qh`egejdm ejydve ih` vhmyqjx`n-

1- Idzyhmzdad`diei vhmyqdjx`eq-

:- _qhzdm yqemzkxqe` ; pqhzdm dmyhqme +pqhzdm h|yhqme ,dmyqeynqjdje$-

7/30/2019 Gasto Ventricular

29/43

_QHZDM H\YHQME

_qhzdm dmyqeynqjdje hzpdqejdm ; + 8 jkL1?

dmzpdqejdm ; + 5? jkL1? Dmzpdqejdm zxjjdm = ``hmein VI

H|pemzdm px`knmeq ; ih` vn`xkhm px`knmeq

7/30/2019 Gasto Ventricular

30/43

H|dzyhm kxjlnz fejynqhz uxh jnmyqn`em `e pqhzdmvhmnze jhmyqe` t qhcx`em h` ``hmein vhmyqdjx`eq7

Fejynqhz 7

5- Vn`xkhm Zemcxmhn ,6?( hm vhmez$ lhknqqecdeihzldiqeyejdm-

1- Cqevhiei- Ynmn vhmnzn- Idzyqdaxjdm ih zemcqh ,8?? k` hmh|yqhkdieihz dmfhqdnqhz adphihzyejdm$-

:- Ynmn vhmnzn phqdfqdjn ,pdh` qdnmhz hzp`jmdjn$-

9- Ankae kxzjx`eq-8- Knvdkdhmynz qhzpdqeynqdnz-

7/30/2019 Gasto Ventricular

31/43

7/30/2019 Gasto Ventricular

32/43

@HT IH @E_@EJH

H` idkhyqn ,q$ vhmyqdjx`eq ydhmh xm hfhjyn fzdjn znaqh `epqhzdm chmhqeie pnq h` vhmyqjx`n-

Hm jxe`uxdhq jkeqe hzfqdje h` qeidn zx jxqveyxqe hz h`

qhzpnmzea`h ih` ve`nq ih `e yhmzdm ih `e peqhi t ihjnmvhqydq `e hm pqhzdm dmyqejevdyeqde-

@e @ht ih @ep`ejh hzyea`hjh uxh `e pqhzdm ihmyqn ih xmehzfhqe hz pqnpnqjdnme` e `e yhmzdm ih peqhi h dmvhqzekhmyh

pqnpnqjdnme` e zx qeidn

_ ; 1Y . q

7/30/2019 Gasto Ventricular

33/43

Yhmzdm ih peqhi ; _qhzdm | Vn`xkhm

@ht ih @ep`ejh 7

Yhmzdm ih peqhi ; fxhqwe `nmcdyxidme` hghqjdie pnq `e jnmyqejjdmih `ez j`x`ez vhmyqdjx`eqhz ,y$-

@e yhmzdm vhmyqdjx`eq e` ejyxeq znaqh `e keze zemcxmhe chmhqe

xme pqhzdm dmyqevhmyqdjx`eq ,_$-

Yhmzdm zdcmdfdje h` hzyqz ih `e peqhi vhmyqdjx`eq-

Hzyqz ; fxhqwe pnq xmdiei ih qhe zhjjdnme`

@e jxqveyxqe ih` vhmyqjx`n ihyhqkdme jxm hfhjydve hz `e yhmzdmih peqhi hm chmhqeq pqhzdm DV-

7/30/2019 Gasto Ventricular

34/43

Qh`ejdm hmyqh hzyqz ih peqhi ,Z$

t jxqveyxqe ih xme hzfhqe lxhje-

Hzyqz hz `e fxhqwe pnq xmdiei ihqhe zhjjdnme` ih peqhi

Hm h` jnqewm ixqemyh `e hthjjdm`e pqhzdm idezy`dje eqyhqde`

jnqqhzpnmih e `e pnzjeqce ih`vhmyqjx`n ,hzyqz vhmyqdjx`eq$

7/30/2019 Gasto Ventricular

35/43

@e @ht ih @ep`ejh t fxmjdm vhmyqdjx`eq hm xm knih`n jd`miqdjn-

_ ; pqhzdm vhmyqdjx`eq q ; qeidn dmyqevhmyqdjx`eq Y ; yhmzdm ynye`

ih peqhi

7/30/2019 Gasto Ventricular

36/43

Dkpnqyemjde ih` hfhjyn ih `e @ht @ep`ejhznaqh h` jnqewm

+ Fejd`dye e hthjjdm vhmyqdjx`eq7

+ _nzjeqce huxdve`h e `e pqhzdm eqyhqde` idezy`dje-

+ Zd jnmzdihqeknz uxh yhmzdm ih peqhi hz dcxe` e

pqhzdm | qeidn . cqnznq ih peqhi-

+ Jnmfnqkh pqncqhze `e hthjjdm vhmyqdjx`eq zhqhixjh h` idkhyqn ih` vhmyqjx`n t yekadm `e

yhmzdm kdnjqidje ih hze kemhqe zh fejd`dyehthjjdm vhmyqdjx`eq-

7/30/2019 Gasto Ventricular

37/43

HFHJYN IH @E _QHZDM EQYHQDE@ZNAQH H@ VN@XKHM IH H\_X@ZDM

Idqhjyn7

E = pqhzdm eqyhqde` 0 vn`xkhm ih hthjjdm-

@e = ketnq peqyh ih `e hmhqce zh jnmzxkh hm

chmhqeq jnmyqejjdm dznkyqdje-

H` dmjqhkhmyn ih qhzdzyhmjde ; 0 vn`- hthjjdm-

Zhjxmieqdnz ,hfhjyn jnkphmzeynqdn$

Zd h` VH zh id`eye h` vhmyqjx`n `n jxe` hzydkx`e h`khjemdzkn ih Fqemb+Zyeq`dmc-

7/30/2019 Gasto Ventricular

38/43

QHCX@EJDM IH @E FXHQWE

JNMYQJYD@

JNMYQEJYDAD@DIEI7

jekadn hm `e hmhqce jnmyqjyd` uxh mn

hz pqnixjdin pnq h`nmcejdm ih `e fdaqekdnjqidje

Zdmmdkn ih dmnyqnpdzkn

H` dmnyqnpn kez dkpnqyemyh 7MNQH_DMHFQDME

7/30/2019 Gasto Ventricular

39/43

HFHJYN DMNYQN_N IH @E MH

Hzydkx`e `e zzyn`h 7 kz pnihqnze t ih khmnq ixqejdm-

H`hvejdm qpdie ih `e pqhzdm vhmyqdjx`eq ip.iy-

Dmjqhkhmye h` ve`nq ih `e fqejjdm ih hthjjdm-

H` vn`xkhm idezy`djn idzkdmxth-

Vn`xkhm ih h|px`zdm zh h`hve yqemzdynqdekhmyh

Fevnqhjh `e idzyn`h ,hfhjyn `xznyqpdjn$-

7/30/2019 Gasto Ventricular

40/43

7/30/2019 Gasto Ventricular

41/43

Hfhjyn ih `e mnqeiqhme`dmeznaqh `e phqfnkemjh jeqieje-

Let dmjqhkhmyn ih `e qh`ejdmi_.iy ih `e pqhzdm k|dke t

qhixjjdm ih `e _IFV t h`ydhkpn ih jnmyqejjdm

Ynin hzyn khgnqe `ephqfnkemjh vhmyqdjx`eq

7/30/2019 Gasto Ventricular

42/43

Hfhjyn ih `e ejydvdiei mhqvdnze zdkpydje cqeixeie znaqh `e jxqveih fxmjdm vhmyqdjx`eq- Nazhqvh uxh `e qhixjjdm ih `e pqhzdm ih``hmein vhmyqdjx`eq exkhmye `e jnmyqejydad`diei-

7/30/2019 Gasto Ventricular

43/43

NYQNZ FEJYNQHZ DMNYQN_NZ

Kix`e zxpqeqqhme` 7 E.ME ,9.5$ ,jeyhjn`ekdmez$-

Inpekdme inaxyekdme ,zdmyydjnz$-

Emcdnyhmzdme DD ,je`jdn"" 1ie fezh$

Je`jdn ""

Yhnfd`dme t jefhdme

Idcn|dme ,dmldadinq ih ankae Me+B+Je$